Evidence base articles and studies supporting the Sensory Trigger MethodTM
Can a person recover speech at home with the help of family and friends without a speech therapist?
The answer is "Yes!"
Materials designed to be used independently or with the help of family and friends are essential to speech recovery. First words and sentences can often be triggered and vocalized within 15 to 20 minutes with a personal Sensory Trigger MethodTM training method done over the phone or Skype. Working with the software programs, then gives you a step-by-step way to go from whatever level you are at to expanding and improving your speech. Families teach their young children to talk--whether they are aware of it or not. It takes about 2 years for the first words to be spoken. In aphasia recovery we are willing to take the same time and attention to help our loved ones relearn language after a stroke or head injury.
Our kit provides everything you need to help with speech recovery. Enlist family members or friends to help set up the computer and working space with the materials. After that, just be available if they need any help and set up the lessons for 3 or more times a week for 30 minutes or more---that's all that it takes. After the first few sessions, many can do the exercises and program with little or no help at all.
If speech therapy is available get our Kit to use along with therapy. It won't interfere--in fact, it will only work to enhance the benefits of speech therapy. Our aphasia software and speech recovery guides and materials are the only ones that are specifically designed so they may also be used in the home by non-professionals.
How can we tell if it is working? How long will it take?
Signs of progress can usually be seen in about 6 weeks, but it take 6 weeks of daily repetitive practice using the Sensory Trigger Technique for the brain to connect to new pathways. Often words will begin to come back before then, because the Sensory Trigger Technique activates pathways that are there, but just haven't been used before. Speech recovery is most often a slow process. We have had some people (we call them "instant talkers"), who were able to say every word in the program as soon as they did the first lesson on the program and triggered the speech using their alternate hand (usually the left). Other people have spontaneously said whole sentences in the first month. We recommend working up to 2 to 2 1/2 years, the same time it takes for a child to learn to speak, though speech many continue to slowly improve after that. Everyone is different.
Is it too late?
We have found that there is no time where it becomes "too late" to start this kind of work. You can start this years after the stroke and still succeed. We have noticed that those that started doing the alternate hand technique soon after their stroke seem to have the fastest and best recoveries. Get started with this as soon as you can--the sooner the better!
Does it work with left-handed people? Does it work for those with no paralysis on either side? Does it interfere with hand movement therapies?
The techniques work the same way for left-handed people. The hand just has to be retrained. Those with no or little paralysis in either hand are still encouraged to use their alternate hand to do these exercises because this will route signals to the undamaged side. So even though they might have regained hand movement in their right hand, they still have to switch to the other hand in order to trigger speech from the other side or the brain. It does not interfere with any therapy they are taking to recover hand movement in their right hand. The person just becomes ambidextrous.
Why didn't speech therapy work?
It's not the speech pathologist's fault. It is the fault of the system. Most aphasia patients can't get enough speech therapy to make much progress. Medicare will now only pay for six sessions. After that, if a patient hasn't progressed, they are disqualified from having any more speech therapy. Medical insurance doesn't do much better. Both Medicare and insurance evaluate the person based on whether or not they are likely to recover enough to go back into the work force. Both stop therapy if a person stops progressing or reaches a "plateau". If you are not going to be able to go back to work you don't qualify. Our research shows that it takes frequent sessions and in severe cases, up to 2 years to recover. Few people can afford that much speech therapy. Sadly, most stroke survivors with aphasia end up at home or in care facilities with no other options to recover speech.
The other reason speech therapy doesn't work, is that the connection to the other side of the brain is never made, so they are just routing language signals to the damaged side which is blocked. The Sensory Trigger MethodTM is based on brain research that most have not heard of before. This is because there is no direct delivery system to get information from the libraries to the university courses to keep up with it. Independent researchers and writers, are very rare in the field.
This is why Stroke Family aphasia programs and speech practice materials can make a big difference. From interviews with our users, we have found that aphasia patients who have stopped progressing in speech therapy, can start progressing again after the family has used our Kit and new brain connections have been made. Our users, many who were not progressing in speech therapy, suddenly start saying the words that were in our program, and then can continue speech therapy because they continue to progress. So don't wait until therapy is over to start using our program and materials.
Can they recover speech just by doing more with their left hand? Why do we need the kit, if we are just learning to use the alternate hand? Our stroke patient has gotten really good with his/her left hand. Why hasn't speech returned?
There is more to it than that. The Kit explains how there are several things that must be combined and put into motion before a connection to the mirror speech center can be made. The exercises are very specific. There are also a list of things that can block speech. The Kit explains how these blocks can be remedied or avoided. The key is not just passively using the alternate hand, but linking it with efforts to speak and accessing the "anchor words", words that route through the undamaged speech center, the words that are most frequently used that are the most connected to or stored in many different places in the brain. Having said that, some people are "reverse dominant" or "mixed dominant" and the right hand may be the best hand to work with. If you have any questions you can always contact us and we will answer any questions you have.
Why not just use a communication device--that is operated by the alternate hand?
We have found that communication devices operated by the left hand do not necessarily bring back speech. We believe this happens for 3 reasons: 1. the other pieces to our method are missing 2. the person actually becomes dependent on the device to speak for them
and 3. the brain learns how to operate the device, but this activity doesn't route the signals to a place in the brain that will relearn how to speak. You can, however, use our Kit along with a communication device. The communication device does help to ease the frustration of not being able to communicate, but everyone we've talked to says it didn't help with speech.
How does this differ from CILT, CIAT or CIT treatment?
On the surface it would seem that the contraint therapy is the opposite of our approach, where in fact, the two approaches are related. There are actually several similarities. Both feature: intensity and frequency; use of trained family members and homework and most important, the constant attempt to talk while not relying on gestures (like pointing), communication devices, writing, drawing or just staying silent.
The left or undamaged arm and hand are placed in a device that constrains them from moving. Though the arm and hand can not move--the person feels the constraint. The constaint device is therefore still causing a "touch" sensory feedback signal. While the constraint is on, the signal is "turned on" 100% of the time. Just like our technique, the touch signal is coming in FIRST--BEFORE visual and auditory cueing prompts the person to speak and the therapist requires an attempt to speak. That forces the brain to develop new pathways through the motor pathways which connect between the arm and hand and the speech motor areas of the brain.
Remember, CIAT or CILT was adapted from a motor therapy technique and at the present time, only works for moderate to mild aphasia, not severe or moderately severe. The average gain is around 36% increase in speech ability though some people have regained significantly more and some regained nothing. CIAT or CILT is a short-term treatment whereas the Sensory Trigger Method is a long-term, ongoing technique to trigger the "touch" sensory pathways to speech. The gains with CILT appear to be permanent gains, but continuing the treatment does not result in more gains. The Sensory Trigger Method, on the other hand, is a long-term method. The recovery continues for however long you use it. The "Sensory Trigger Method" works for severe aphasias and is a practical approach for long-term speech recovery. CILT is mysteriously a "hit or miss" therapy and whereas CIAt or CILT is a short-term therapy, STM speech recovery can continue to progress for years after their stroke or brain injury. If you are having CILT or CIAT treatment, we recommend waiting until after your CIAT OR CIT treatments have ended before starting the Sensory Trigger Method.
We do not claim the Sensory Trigger Method will be 100% effective for everyone, however almost everyone gains improvement and recovers some level of speech. This depends on the ability to "stick with it". It may require several years of daily speech practice to make a really significant recovery because there are so many factors that impact speech recovery. Those with facial paralysis or trouble with swallowing might not be able to talk, but they can regain communication in other language functions such as reading, writing and comprehension of spoken language. For those with severe brain damage, it can take a long time for the new pathways for speech to form to progress from simple levels to more complex and fluent speech. Those with apraxia or "dyspraxia" as it is called in the UK, will take longer to recover using our programs and methods. Adult apraxia programs and therapists are exceedingly rare. This is because adult apraxia is still classified as "incurable". The Sensory Trigger Method and our StM programs are one of the only ones to actually work with adult apraxia--whether it is severe or is one of the milder forms. Often this means that altThough the person may always have apraxic tendencies, they can learn to "manage their apraxia" and regain the ability to communicate to an impressive degree if they make new pathways in the brain using the Sensory Trigger Method.
Do we have to have a computer to use this method? No--althought the programs in someways really make it possible to follow the method and progress through progressive stages. STM can be done independently using just the hand and a person trained in the method and techniques. STM training and one-on-one consulting for therapists and family members is available. Contact us for more information.
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© 2013 Barbara Dean Schacker